Joan Stephenson

Diabetes Drug May Be Associated With Increase in Risk of Bladder Cancer

longer period of time.” Brooksaddedthat the findingsshould alert physicians and others involved in poststroke care that these patients probablyneedmoreintensivetherapythanthey havebeenreceiving.“Atypicalpatientwill seea strokephysician forayearand then be sent to a primary care physician,” Brooks said. “But the primary care physicianwillbemoreconcernedwith treating emerging comorbidities as these patients get older, and they may not notice all the residual effects of the stroke.” Wolfe says he hopes his findings will help direct future research. “Through our follow-up and assessment of cognition, depression, and activities of daily living, we can start to model which people will have these poor outcomes,” Wolfe said. “We now need to develop good predicative factors such as perhaps living alone, or having a right-sided stroke, or whatever. We also show the need for long-term studies of the efficacy of therapies, which are often approved based on 1-year studies.”

CDC Tracking Enterovirus D-68 Outbreak Causing Severe Respiratory Illness in Children in the Midwest

ticularly concerned about companies marketing e-cigarettes to youth. Aruni Bhatnagar, PhD, lead author of the AHA policy statement and a professor of medicine at the University of Louisville, noted that there are more than 7000 flavors of e-cigarettes, includingbubblegumandother candy-like flavors. He said he is concerned that companies are using the flavors to attract youth. “I think they are targeting e-cigarettes to youth by passing them off as safe, desirable, trendy, and easily accessible,” Bhatnagar said. “We don’t want to create a new generation of nicotine addicts.” The WHO has urged regulators to ban flavors in e-cigarettes to make them less attractive to youth.

Scientists Explore Use of Anti-HIV Drugs as a Means to Slow HIV Transmission

SAN FRANCISCO—As the number of new HIV infections continues to outstrip treatment capacity, the need for better prevention strategies becomes ever more apparent. Although attempts to develop an HIV/AIDS vaccine have been discouraging, other approaches to slow the spread of HIV are sparking interest, report researchers at the 17th Conference on Retroviruses and Opportunistic Infections. Studies are under way to assess whether a strategy known as “test and treat”—large-scale testing of individuals for HIV infection and initiating treatment with antiretroviral drugs in those who test positive—can help reduce HIV transmission. Scientists also are exploring whether using antiretrovirals in pills and in vaginal gels will offer protection against HIV infection, especially in those with a heightened risk of infection, such as partners of HIV-infected persons and commercial sex workers.

To Stretch or Not to Stretch

Over the past few years there have been many debates on how athletes should warm up and stretch prior to activity. The original school of thought was a light jog followed by static stretching. The reasoning behind this is a stretched muscle has less chance of being injured and is therefore ready for activity. Through the increased range of motion acquired through acute static stretching, it was believed an athlete would then improve performance on the field. In reality, these athletes were decreasing their performance. In their study on World Class Rugby Players, Fletcher and Jones stated, ”when stretching a muscle statically, the amount of force that could be generated from the muscle to the skeletal system is actually reduced through neural inhibition and decreased muscle-tendon compliance. This change in muscle-tendon compliance leads to a decrease in the musclulotendinous unit’s (MTU) ability to store elastic energy, thus decreasing speed and power.” In other words, if an athlete performs static stretching on the active muscles prior to activity, the body’s ability to store elastic energy is decreased, leading to a marked decrease in performance. This has been shown recently in numerous studies. Below are excerpts from 5 of these studies:

CDC: Ebola Risk to US Patients Is Low, But Clinicians Should Be on Alert

Oneworry is that risingheroinusemay be a sign that individuals are shifting from prescription opioid abuse to other opioid drugs. From 2010 to 2012, Florida saw a 24%decreaseinoxycodoneprescribingbut a37%increaseinmorphineprescribing.The state also saw an increase in heroin overdose deaths during the same period, from 48 to 108 (0.3 to0.6 per 100 000people in the state). Johnsonsaid this increase, althoughconcerning, is small comparedwith the simultaneous reductions in prescriptionoverdoses,whichdecreasedfrom2722 in 2010 to 2116 in 2012. This reduced the prescription overdose rate to 11 per 100 000, the lowest in the state since 2007, according to the report on Florida’s efforts. Paulozzi said economic factors and greater availability of heroin may be drivingsomeopioiduserstoheroin,ashasbeen reported in some surveys. But there aren’t cleardataexplainingwhyheroinusehas increased in thenortheasternUnitedStates. For now, the CDC is focusing on preventing prescription opioid abuse. “We are interested in upstream interventions,” said Paulozzi. “We want to get ahead of the problem before people become dependent and prevent them from turning toheroinbecauseof its lowerprice and high availability.”

Study Halted: No Benefit Seen From Antiretroviral Pill in Preventing HIV in Women

This article explains the decision to halt a study that introduced a daily antiretroviral pill among women who are considered high risk for contracted HIV. A brief trial period revealed that the pill was not entirely effective. Results showed that almost the same number of women contracted HIV in the control and study groups. This could have been caused by a lack of adherence unexpected drug interactions or unknown factors. This is not necessarily a reflection on the protective abilities of the pill. Instead these results point to the need for further analysis and research.

Largest-Ever Ebola Outbreak Still Simmering in West Africa

washout before beginning the second 12week phase. The researchers used several measurementstoassesssymptoms,includingstereotypy (self-stimulatory behavior), repetitive behavior, and rigidity or craving for sameness. In their interim analysis of this pilot study, they demonstrated the feasibility and safety of using TSO in an adult population with autism and have found a potential benefit from treatment in all these domains. Hollander’s team is in the process of launching a new study of this same approach in a pediatric population with ASD, based on the idea that early intervention in developmental disorders is optimal. In a different therapeutic approach, Hollander and his colleagues studied 10 children with ASD who had a history of symptom improvement when they had fevers. All the children spent alternate days soaking in a hot tub at 102°F (to mimic fever) or at 98°F (control condition). The children showed improvements on the days when their body temperature was raised to 102°F, compared with the days they were bathed at 98°F. Benefits were seen particularly in restricted and repetitive behavior as well as social behavior, said Hollander. The mechanism of action is under investigation, but researchers conjecture that raising the body’s temperature either through fever or a hot tub bath releases anti-inflammatory signals that can bring about the observed behavioral effects. Future studies need to be done to replicate many of these findings. But researchers suggest the data represent a step toward personalizing therapies for psychiatric and neurodevelopmental disorders and provide promise for the development of inflammatory biomarkers and treatment approaches for patients who are responsive to immune-targeted therapies.

ICMJE: All Authors of Medical Journal Articles Have “Responsibility to Stand by the Integrity of the Entire Work”

In its latest revision to its recommendations for researchers submitting scientific articles to medical journals, the International Committee of Medical Journal Editors (ICMJE) has added a new requirement that emphasizes the responsibility of each author to stand by the integrity of the entire work (http://bit.ly/16h2Vna). Recommendations from the ICMJE are followed by hundreds of medical journals worldwide. The participating journals and organizations and their representatives who approved the revised recommendations include 12 journals (including JAMA), the US National Library of Medicine, and the World Association of Medical Editors.

HIV Studies: Progress in Microbicides, Dead End for an Immune-Boosting Strategy

MONTREAL, CANADA—After years of disappointing attempts to develop a vaginal microbicide that helps protect women from HIV infection, researchers announced preliminary findings from the first trial to show promising results. In addition to these findings, presented at the 16th Conference on Retroviruses and Opportunistic Infections, other encouraging news on the prevention front came from studies in macaque monkeys that found that antiretroviral drugs, given by mouth or in a vaginal gel, offered some protection to the animals from infection with SHIV, a virus containing components of HIV and a related monkey virus that mimics HIV infection and causes serious illness in macaques. With no effective HIV vaccine on the horizon, an effective microbicide would be a major component in prevention efforts. Because microbicides can be applied without the knowledge of a sexual partner, they could be particularly useful for those women who cannot refuse sex or negotiate condom use with their male partners.

HIV Prevention Studies Yield Mixed Results

BOSTON—Analyses of results of a trial of a failed HIV vaccine have prompted some prominent scientists to urge the National Institutes of Health (NIH) to retreat from testing candidate vaccines of questionable value and to return to the laboratory to develop new approaches. Whether or not the agency will move to scale back vaccine trials, scientists agree that with no prospect of an effective vaccine to curb the HIV/AIDS pandemic in the foreseeable future, expanding the repertoire of prevention tools is all the more important. New findings from studies of varying prevention strategies, including male circumcision and the use of antiretroviral drugs to curb HIV transmission during breastfeeding by mothers in resource-poor settings, were presented here at the 15th Conference on Retroviruses and Opportunistic Infections.